Literature DB >> 28993891

Value of antibiotic prophylaxis in routine knee arthroscopy : A retrospective study.

Yongjian Qi1, Xu Yang1, Zhengqi Pan1, Hua Wang1, Liaobin Chen2.   

Abstract

OBJECTIVE: Prophylactic antibiotic use prior to routine knee arthroscopy remains controversial. It is important to know whether antibiotics help decrease the surgical site infection (SSI) rate. Our aims were to assess the efficacy of antibiotic prophylaxis in preventing SSI and to identify risk factors for SSI following routine knee arthroscopy without an implant.
METHODS: A retrospective study was conducted using the electronic medical records at the authors' hospital to identify patients that underwent routine knee arthroscopy without an implant between October 2010 and October 2016. Data on demographics, clinical characteristics and antibiotic administration were extracted. Arthroscopic diagnosis, debridement, partial or complete meniscectomy, arthroscopic shaving and microfracture, removal of loose bodies, synovectomy and lateral retinacular release were included. Complex knee arthroscopy with an implant was excluded. Patients were divided into evaluation (with prophylactic antibiotics) and control (no antibiotic treatment) groups. Continuous variables between groups were compared using the Student's t-test. Data were analyzed using the Chi-squared test for percentages between groups. Multivariate logistic regression was used to identify independent risk factors of SSI.
RESULTS: Of 1326 patients, 614 (46.3%) received prophylactic antibiotics, while 712 (53.7%) did not. There were seven (0.53%) SSIs. The SSI rate did not differ significantly between patients receiving antibiotics (0.49%, three) and those not (0.56%, four). Five patients (0.37%) had superficial infections, two (0.33%) were in the prophylactic antibiotic group and three (0.42%) were in the other group. Deep infections occurred in two patients (0.15%), one (0.16%) in the prophylactic antibiotic group and one (0.14%) in the other group. The difference between the two groups was not statistically significant (P = 1.0). Age over 50 years was associated with an increased risk of SSI (relative ratio [RR] = 1.469, 95% confidence interval [CI] 1.09-2.13, P = 0.009).
CONCLUSIONS: Prophylactic antibiotic use in routine knee arthroscopy without an implant may not be necessary. Age over 50 years was associated with an increased risk of SSI.

Entities:  

Keywords:  Implant; Methicillin-resistant Staphylococcus aureus; Prophylactic antibiotics; Routine knee arthroscopy; Surgical site infection

Mesh:

Year:  2018        PMID: 28993891     DOI: 10.1007/s00132-017-3486-3

Source DB:  PubMed          Journal:  Orthopade        ISSN: 0085-4530            Impact factor:   1.087


  34 in total

1.  Antibiotic-associated diarrhea.

Authors:  Phillip Periman
Journal:  N Engl J Med       Date:  2002-07-11       Impact factor: 91.245

2.  Surgical site infections after arthroscopy: Outbreak investigation and case control study.

Authors:  Hilary M Babcock; Cathy Carroll; Matthew Matava; Paul L'ecuyer; Victoria Fraser
Journal:  Arthroscopy       Date:  2003-02       Impact factor: 4.772

3.  Medication errors, routines, and differences between perioperative and non-perioperative nurses.

Authors:  Linda A Treiber; Jackie H Jones
Journal:  AORN J       Date:  2012-09       Impact factor: 0.676

Review 4.  Antibiotic prophylaxis in orthopaedic surgery: difficult decisions in an era of evolving antibiotic resistance.

Authors:  D J Bryson; D L J Morris; F S Shivji; K R Rollins; S Snape; B J Ollivere
Journal:  Bone Joint J       Date:  2016-08       Impact factor: 5.082

5.  A method of arthroscopic surgery. Clinical evaluation of synovectomy with the electric resectoscope and removal of loose bodies in the knee joint.

Authors:  H Aritomi; M Yamamoto
Journal:  Orthop Clin North Am       Date:  1979-07       Impact factor: 2.472

6.  Control of antibiotic resistance in China must not be delayed: The current state of resistance and policy suggestions for the government, medical facilities, and patients.

Authors:  Qi Tang; Peipei Song; Jiajia Li; Fanlei Kong; Long Sun; Lingzhong Xu
Journal:  Biosci Trends       Date:  2016-02       Impact factor: 2.400

Review 7.  Cephalosporin antibiotics as applied in surgery of bones and joints.

Authors:  H C Neu
Journal:  Clin Orthop Relat Res       Date:  1984-11       Impact factor: 4.176

8.  Efficacy of Prophylactic Antibiotics in Simple Knee Arthroscopy.

Authors:  Ronald W B Wyatt; Gregory B Maletis; Liisa L Lyon; Joan Schwalbe; Andrew L Avins
Journal:  Arthroscopy       Date:  2016-06-30       Impact factor: 4.772

Review 9.  Prophylactic antibiotics in hip and knee arthroplasty.

Authors:  John Meehan; Amir A Jamali; Hien Nguyen
Journal:  J Bone Joint Surg Am       Date:  2009-10       Impact factor: 5.284

10.  Septic arthritis following arthroscopy, with cost/benefit analysis of antibiotic prophylaxis.

Authors:  G L D'Angelo; D J Ogilvie-Harris
Journal:  Arthroscopy       Date:  1988       Impact factor: 4.772

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  3 in total

Review 1.  Consensus Guidelines on Interventional Therapies for Knee Pain (STEP Guidelines) from the American Society of Pain and Neuroscience.

Authors:  Corey W Hunter; Timothy R Deer; Mark R Jones; George C Chang Chien; Ryan S D'Souza; Timothy Davis; Erica R Eldon; Michael F Esposito; Johnathan H Goree; Lissa Hewan-Lowe; Jillian A Maloney; Anthony J Mazzola; John S Michels; Annie Layno-Moses; Shachi Patel; Jeanmarie Tari; Jacqueline S Weisbein; Krista A Goulding; Anikar Chhabra; Jeffrey Hassebrock; Chris Wie; Douglas Beall; Dawood Sayed; Natalie Strand
Journal:  J Pain Res       Date:  2022-09-08       Impact factor: 2.832

2.  Should antibiotics be administered before arthroscopic knee surgery? A systematic review of the literature.

Authors:  John Carney; Nathanael Heckmann; Erik N Mayer; Ram K Alluri; Carleton Thomas Vangsness; George F Hatch Iii; Alexander E Weber
Journal:  World J Orthop       Date:  2018-11-18

3.  Knee septic arthritis caused by α-hemolytic Streptococcus in a patient with a recent history of knee arthroscopy: a case report.

Authors:  Giovanni Balato; Tiziana Ascione; Paolino Iorio; Cristiano De Franco; Vincenzo De Matteo; Alessio D'Addona; Nicola Tammaro; Achille Pellegrino
Journal:  BMC Infect Dis       Date:  2019-10-24       Impact factor: 3.090

  3 in total

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